Florida's Aging Population

Pepper Institute on Aging and Public Policy
636 West Call Street

Florida State University
207 Pepper Center
Tallahassee, Florida 32306-1121
February 20, 2015
Dear Reader:
We hope you find the 4th edition of Florida’s Aging Population: Critical Issues for Florida’s
Future informative and helpful. This publication is produced by the Pepper Institute on Aging
and Public Policy at Florida State University, with financial support from the Claude Pepper
Center. The purpose of this report is to provide elected officials, policy analysts, advocacy
organizations, and others interested in Florida’s future with a snapshot of older adults in Florida,
a highlight of key policy issues they face, and tentative projections for their future. This edition
focuses on the Great Recession of December 2007 to June 2009 and its enduring implications for
retirement security. We also highlight the ongoing need for affordable, quality long-term care.
The Florida legislature and U.S. Congress will consider and weigh in on many bills and funding
decisions this year that can dramatically shape the quality of life of Florida’s aging population.
Some of these concern the issue of access to quality care, like the Caregiver Advise, Record,
Enable (CARE) Act, developed by the AARP, or Florida’s Community Care for the Elderly
(CCE) program. Both older adults in Florida and their caregivers stand to benefit by lawmakers
enacting legislation such as the CARE Act and adequately funding programs like CCE.
Equally pressing is the need to practice responsible stewardship of the Florida Retirement
System (FRS). Currently more than 360,000 retirees receive benefits from the FRS, while
648,000 state employees are active participants in the system. This means that changes to the
FRS impact a population the size of Orlando, Tampa, and Miami combined. Further, Florida’s
citizens more urgently need policymakers to address the viability of Florida’s municipal pension
plans (Report Card Update: Florida Municipal Pension Plans, LeRoy Collins Institute at FSU).
Of course, we all share responsibility for helping Florida’s older adults remain independent and
active, and solutions to the challenges they face are not limited to state and federal legislation. At
the Pepper Institute we are encouraged by the successes of organizations that come together to
develop novel programs and solutions that truly enrich the lives of Floridians in their “golden
years.” We note two of these in this report – the Osher Lifelong Learning Institute at FSU and
the Safe Mobility for Life Coalition coordinated by the Florida Department of Transportation.
Thank you for all you do on behalf of Florida’s older adults and the people who care for them.
Sincerely,
John Reynolds
Eagles Professor of Sociology
Director, Pepper Institute on Aging and Public Policy
FLORIDA’S AGING POPULATION
Critical Issues for Florida’s Future | 2015
John Reynolds, Justine Gunderson, and Melissa Bamford
1 pepperinstitute.fsu.edu
Annual_Report_Pepper_FINAL.indd 1 1/27/2015 4:06:42 PM

Pepper Institute on Aging and Public Policy 2

Executive Summary
This report is the fourth volume in a continuing series on the status of Florida’s
aging population, produced by the Pepper Institute on Aging and Public Policy
with funding from the Claude Pepper Center at Florida State University. The series
is designed to provide up-to-date information on the aging population in Florida, on the major
economic and medical issues that confront them, and on the public programs and policies that
contribute to older adults’ safety, security, and general well-being.
In this edition we first present an overview of Florida’s growing aging population relative to other
states as well as specific information regarding aging trends for Baby Boomers. Florida remains
the “oldest” state in the union, in terms of its population composition, and is second only to
California in terms of the total number of older adults. Florida likewise has the oldest county in
the nation, Sumter County, where over 43 percent of the residents are 65 and older, with many
of them living in The Villages, the largest 55-and-older retirement community in the U.S. Given
the size of the older adult population in Florida, the resources and experience they bring to
their communities, and the demands they place on state, county, and municipal services, Florida
remains a bell-weather state for aging issues in our country. The status of older adults in Florida
and the policies that affect their well-being are instructive for the rest of the country, as we all
face challenges and opportunities related to the Baby Boom cohort entering older adulthood.
This report places special emphasis on the impact of the severe economic downturn that
began in 2007, including its implications for Social Security and Medicare. Many Americans
experienced significant financial setbacks as a consequence of this “Great Recession.” However,
older Americans were hit particularly hard. Many have experienced stretches of unemployment
and layoffs, savings depletion, and a decline in the value of their homes—leaving some older
Americans wondering how they will be able to retire as planned during these times of economic
uncertainty. The length of unemployment during the peak of the recession for workers aged 55
and older averaged eleven months and only one-third of workers aged 55 to 64 who lost their jobs
during the recession were able to find full-time employment by 2010. According to one AARP
study, nearly two-thirds of Baby Boomers suffered a reduction in retirement savings and almost
one in four older workers spent nearly all of their retirement savings during the first two years of
the recession. Many older adults are now left wondering if they’ll ever be able to retire.
The Great Recession also had a profound effect on the public programs meant to shelter older
adults from economic hardship. The financial health of Social Security and Medicare, both
important programs for older Americans, took a hit following the economic downturn. Social
Security assets declined during the midst of the Great Recession just as many Baby Boomers
were set to retire, and Medicare continues to struggle to maintain adequate financing in the face
of rising health care costs and increased demand for health services by older adults. According
to Medicare’s Board of Trustees, Medicare’s Hospital Insurance fund is currently expected to be
depleted by 2028. The future of these major social programs is the top aging policy issue facing
our country, and it is the hope of the Pepper Institute on Aging and Public Policy that this report
will prove helpful to policymakers and aging advocacy groups in facing that historic challenge.

Copyright © Pepper Institute on Aging and Public Policy, 2015

The Organization of This Report
This report is organized into four sections. Each section
reports relevant information for Florida for the most recent
dates available. The first section provides an overview of
Florida’s aging population and describes in broad strokes
the Great Recession of the late 2000s. The second section
details population trends in Florida since 1970, noting
within Florida differences at the county level and provides
specific information about aging trends for Baby Boomers.
The third section details the recession’s impact in terms
of unemployment, layoffs, income, poverty rates, savings,
foreclosures, and Social Security and Medicare depletion.
The fourth section highlights the costs of health care and
insurance for Florida’s population in terms of costs of
long term care facilities, Medicare/Medicaid costs and also
provides information on insurance coverage.
About the Authors

John Reynolds, PhD, is Professor of Sociology and the
Director of the Pepper Institute on Aging and Public Policy
at Florida State University. His recent research examines
the downsides of indebtedness and the politics of school
reform.
Professor Reynolds also is on the leadership team of
Florida’s statewide Safe Mobility for Life Coalition whose
mission is to improve the safety, access, and mobility of
Florida’s aging road users.
Justine Gunderson is a PhD candidate in the Department
of Sociology at Florida State University. Her dissertation
research investigates trends in grandparenting ideologies,
particularly the rise of intensive grandparenting, and its
increasingly important implications for the life satisfaction
of seniors.
Melissa Bamford, PhD, is an Instructor of Sociology at the
University of Memphis.

Claude Denson Pepper (1900-1989)

About the Pepper Institute
The Pepper Institute on Aging and Public Policy serves as
a focal point for aging research and education at Florida
“Life is like riding a
State University. Resources are devoted to supporting
individual and collaborative faculty research projects and bicycle: you don’t fall
funding graduate student education. Research activities off unless you stop
include health policy, access to health care and health care pedaling.”
financing, aging and social change, work and retirement,
and social welfare and social security reform. The Pepper - Claude Pepper
Institute is also affiliated with the Safe Mobility for Life
Coalition and the Osher Lifelong Learning Institute.
Funded by the Florida Department of Transportation, the
Safe Mobility for Life Coalition is a statewide source for
materials and information related to maintaining older
driver safety and mobility. The Osher Lifelong Learning
Institute now includes over 1,000 members who participate
in a wide range of activities, classes, local excursions,
and international study. Together, the Pepper Institute
is committed to fostering life-long learning through
community engagement and outreach.
Pepper Institute on Aging and Public Policy

College of Social Sciences and Public Policy,
Florida State University
Tallahassee, Florida 32306-1121
(850) 644-2831 | pepperinstitute.fsu.edu


Table of Contents
Florida’s Aging Population 11
Florida’s Status Relative to Other States 12
Population Trends Since 1970 13
Florida’s Aging Population by County 14
Florida’s Median Age 15
Florida’s Growing Aging Population 15
The Growth of the “Oldest Old” 17

Baby Boomers: The Future of the Aging Population 18
Living Arrangements 19
The Great Recession 21

An Overview 22
Migration: Florida as a Retirement Destination 23
Unemployment 25
Layoffs 26
Income 28
Poverty 30
Foreclosures 33
Savings 35
Impact on Social Security and Medicare 36
Health Care, Insurance Costs 39

Long Term Care 40
Medicare and Medicaid Costs 42
Insurance Coverage 43
Concluding Remarks 45
Programs Affiliated with the Pepper Institute 47

Safe Mobility for Life Coalition 48
The Osher Lifelong Learning Institute 50


Florida’s Aging Population

Florida’s Aging Population
Reflecting the growth of the older population as a whole, the 2010 Census
demonstrates that more people were 65 and older in 2010 than in any other
Census. In fact, the overall population aged 65 and older increased at a faster
rate than the total U.S. population overall—a growth rate of 15.1 percent
compared to 9.7 percent.1
Florida’s Status Relative to Other States

Florida is ranked:
As the fourth most populous state in the United States,
Florida is home to 5.5 percent of the nation’s people. As • 1st in the proportion
of the 2010 Census, around 3.26 million persons age 65 of people aged 65
and older were residing in Florida. While this is not the
and older
largest older adult state population in the country, at
17.3 percent Florida has the highest percent of residents • 14th in average life
age 65 and older.2 In contrast, 13.7 percent of the U.S. expectancy: 79.7
population is 65 plus.3
years
The most current projections published by the Census
Bureau show that Florida’s elderly population will grow • Our median age is
rapidly in the next several decades, both absolutely and 40.4 years
as a percent of the state population. By 2030, the size
of Florida’s 65 and older population is projected to be • 17 percent of Florida
7.77 million, more than twice what it was in 2010. This residents are 65
number will comprise about 27 percent of Florida’s total years and older
population, and Florida is one of a handful of U.S. states
projected to have at least one-quarter of its population
age 65 and older by 2030 (other states included Maine,
Wyoming, New Mexico, Montana, and North Dakota).4
Within Florida, the age distribution of the population varies substantially by
county. As of 2010, there were 3 counties with a median age below 30: Hendry,
Leon, and Alachua. The “oldest” counties in Florida have a median age of 50
or older and these include: Charlotte, Citrus, Sarasota, Highlands, Flagler,
Hernando, Martin, and Sumter.5
1 U.S. Census Bureau (2005). State Interim Population Projections by Age and Sex: 2004-2030.
Retrieved from http://www.census.gov/population/www/projections/stproj.html
2 U.S. Census Bureau. (2010). Profile of the General Population and Housing Characteristics: 2010.
Retrieved from http://factfinder2.census.gov
3 U.S. Census Bureau (2005), op. cit.
4 U.S. Census Bureau. (2005), op. cit.
5 The Florida Legislature Office of Economic and Demographic Research. (2012, May 11). Florida’s

Population Trends Since 1970
Florida experienced tremendous
population growth from 1970
to 2010, growing from just
under 16 million residents
in 2000 to almost 19 million
residents in 2010. In fact,
Florida’s population is expected
to grow to over 23 million
people by 2030.6 Adding to this
growth, the overall population
is forecasted to increase by
just under 250,000 residents
between 2025 and 2030—a
number roughly equivalent to
the city of St. Petersburg.7
Florida’s population growth slowed down in the wake of
the Great Recession. Leading up to the recession (2000 to
2006), the average annual population increase was around
362,000 individuals, while the average annual increase
during the recession was less than half that amount at
114,000 individuals.
Reflecting the fact that Florida ranks third in the number
of foreign-born residents, most of the growth in Florida’s
population is a result of net migration. By 2030, net
migration is expected to encompass over 90 percent of
Florida’s population growth. While Florida has been
leading the nation in terms of a demographic transition
towards an aging population, the future of Florida’s age
structure reflects not only aging Floridians, but also the
people who will migrate to Florida in the future. Without
migration, the age structure of Florida in 2030 would be
dramatically older.
Economic Future & the Impact of Aging in Place. 1st Annual Statewide Ag-
ing in Place Housing Summit. Retrieved from http://edr.state.fl.us
7 U.S. Census Bureau (2010). Profile of the General Population and
Housing Characteristics: 2010, op .cit.

Florida’s Aging Population by County
Most of the counties in Florida have older populations than the U.S. overall. In
2010, 51 out of Florida’s 67 counties exceeded the US percent of the population
aged 65 and older. Statewide, the overall percentage of the population aged 65
remained fairly stable from 2000 to 2010—decreasing from 17.6 percent in 2000
to 17.3 percent in 2010. However, the percent of the population aged 65 and
older increased in 41 counties and decreased in 26 counties.8 This indicates that
despite stability at the state level, many counties have needed to respond to
changing demands on services for different age groups.
Median
(April 1, 2010)
Age of Floridians
Holmes
Jackson
bia
Santa Rosa Okaloosa

Escam
Washington Jefferson Nassau

Walton Gadsden
Hamilton
Calhoun Leon Madison
Duval
Bay Liberty Baker
Suwannee
Wakulla Columbia
Taylor
Union
hns
Gulf Clay
Franklin Lafayette Bradford
St. Jo
Gilchrist
Alachua Putnam
Dixie
Flagler
Levy
Marion
Volusia
Citrus
Seminole
Legend Hernando
Sumter
Lake
Orange
Pasco
29.6 - 36.2
Hillsborough
36.3 - 40.6 Osceola
llas
Polk Brevard
40.7 - 44.1
Pine
Indian River
44.2 - 49.7
Manatee Hardee Okeechobee
49.8 - 62.7 St. Lucie
Highlands
DeSoto
Sarasota
Martin
Glades
Charlotte
Hendry Palm Beach

Lee
Broward
Collier
Monroe Miami-Dade

Within counties, age distributions vary considerably.
The northern part of the state has a relatively young
population—at least by Florida standards. The middle
region of the state is the oldest, particularly counties In 2010, 51 out
located along the Gulf Coast from Levy to Collier county,
where 20 to 40 percent of all residents are at least 65 years of Florida’s 67
of age or older.9 counties exceeded
the US percent
Florida’s Median Age of the population
Another way to gauge the aging of Florida is by tracking aged 65 and older.
changes in the median age of the population. (The median
is the age at which half of the population is older and half
are younger.) The median age of Florida residents was 40.7
years as of 2010—an increase from 37.6 years in 2002.10
The aging of the Baby Boom generation into the older age
groups has been a central contributing factor to the increase
in the median age within Florida, as well as the Unites
States as a whole.11
In 2010, Florida did not have the highest median age, but
compared to other states that also had a median age of 40
years old or above, Florida had both the greatest number
and percentage of residents aged 65 and older. In fact, four
of the top ten cities with the highest percentage of residents
aged 65 and older were located in Florida: Clearwater,
Hialeah, Cape Coral, and Miami.
Florida’s Growing Aging Population

Florida’s aging population is growing rapidly. While
Florida’s population is expected to grow by almost 5.1
million between 2010 and 2030, Florida’s older population
will account for most of Florida’s population growth,
representing 55.2 percent of the gains in population. It is
9 Hardy, M.A. (2002). Florida’s Aging Population: Critical Issues for
Florida’s Future. Pepper Institute on Aging and Public Policy. Florida State
University.
10 U.S. Census Bureau (2010). USA People QuickFacts, op. cit.
11 U.S. Census Bureau (2010). Profile of the General Population and
Housing Characteristics, op. cit.

predicted that by 2020 the number of Florida residents aged 65 and older will
total 4.6 million.12
As of 2010, there were 2.5 million Floridians in their 50s, 2.1 million Floridians
in their 60s, 1.4 million Floridians in their 70s and almost 1 million Floridians
in their 80s and above. Seeing as Florida ranked as the third most popular state
when people aged 66 and older were asked to indicate where they would choose
to live in a 2011 Harris Poll, we can expect that these numbers will continue
to rise. Recent estimates predict that Florida’s 65 and older population will
represent 24.1 percent of Florida’s overall population by the year 2030.13
Florida’s Percent Population Growth By Age Group

2010 to 2030
28
26
24
22
20
18
16
14
12
10
8
6
4
2
0
0-17 18-29 30-39 40-49 50-59 60-69 70-79 80+
12 U.S. Census Bureau. (2010). USA People QuickFacts, op. cit.

13 U.S. Census Bureau. (2010), Profile of the General Population and Housing Characteristics, op.
cit.

The Growth of the “Oldest Old”

The Growth of the “Oldest Old”
The “oldest old”—defined as those aged 85 and older—
is expected to climb from 5.9 million to 18.2 million to Florida’s population
comprise roughly 4.3 percent of the total population.
Due to advances in public health and medical care,
is expected to
this age group in the U.S. is expected to almost triple grow by almost 5.1
between 2012 and 2060.14 million between
While the proportion of women in Florida’s 2010 and 2030
population is greater than men at all adult ages,15 the and the growth
surplus of women over men is especially noticeable
when examining the proportion of Floridians aged of Florida’s older
85 and older. On average, two out of three Floridians population will
aged 85 and older are women.
account for most of
Between the years 2000 and 2010, the number of this growth.
Floridians aged 85 and older grew by 102,824 people,
or 3.7 percent, compared to the increase in Florida’s
population by 2.8 million residents, a nearly 18 By 2020 the number
percent increase overall.16 Florida’s 85 and older of Florida residents
population is projected to nearly double by the year aged 65 and older
2020.17 Florida’s unique demographic composition and
rapidly expanding 85 and older population means that is expected to reach
Florida will serve as a prototype for other states also 4.6 million.
experiencing increasingly aging populations.
Baby Boomers: The Future of the Aging Population

Baby Boomers, defined by the Census Bureau as the generation of Americans
born during the “baby boom” from 1946 to 1964 during the post-World War II
period, are important not only due to their size, but also because many are just
now beginning to enter retirement age. The earliest Baby Boomers first started
to reach age 65 in 2011. The number of older people is projected to dramatically
14 U.S. Census Bureau. (2012 December). U.S. Census Bureau Projections Show a Slower Growing,
Older, More Diverse Nation a Half Century from Now. Retrieved from http://www.census.gov/news-
room/releases/archives/population/cb12-243.html
15 Macpherson, D. (2007). Florida’s Aging Population: Critical Issues for Florida’s Future. Pepper
Institute on Aging and Public Policy. Florida State University.
16 Florida Bureau of Economic and Business Research. (2010). Florida Population by Age Group.
Florida Population Studies. Retrieved from http://edr.state.fl.us/Content/population-demographics/data/
Pop-Census_Day.pdf

increase for the next 18 years as younger Baby Boomers
age. The population aged 65 and above is expected to grow
from nearly 35 million now to about 71.5 million by the
year 2030 becoming nearly 20 percent of the total U.S. The earliest Baby
population.18 This means that by the year 2030, nearly one
in every five Americans will be over the age of 65.19 Boomers reached age
65 in 2011.
The Census Bureau predicts that by 2015 the share of
Floridians aged 65 and older will rise to 19.5 percent and By 2030 nearly 1 in
will continue to increase to over 27 percent by the year
2030. Yet, the impact of the aging of the Baby Boomers for
5 Americans will be
Florida’s future lies not only in how many Baby Boomers over the age of 65.
now reside in Florida—but whether large numbers of
Boomers currently living in other states will choose to
retire in Florida. Historically, Florida has been a prominent
destination for retirees from both the Northeast and the
Midwest, but whether it will continue to be so is not certain
in the context of the recession and its aftereffects.
Living Arrangements
Top among the concerns of older adults and their family
members is where they will live as they age. Nearly all older
adults hope to remain in private homes with or without a
spouse, but some will eventually reside in assisted living
facilities or nursing homes. Of households aged 65 and By 2015 nearly 20
older, the most common living arrangement was for older
adults to reside with their spouses.20 This pattern holds in
percent of Floridians
Florida as well, with 69 percent of men and 43 percent of will be 65 and older.
women living with their spouse.21
In Florida, 17.2 percent of men aged 65 and older lived
alone, compared with nearly 32 percent of women. 2.3
percent of women aged 65 and older lived in group
quarters or institutions, such as long-term care facilities,
18 U.S. Census Bureau. (2012 December), op. cit.

19 Federal Interagency Forum on Aging-Related Statistics. (2008).
Number of People Age 65 and Over, by Age Group. Retrieved from http://
www.agingstats.gov/Main_Site/Data/2008_Documents/Population.aspx
20 U.S. Census Bureau. (2012 December), op. cit.
21 American Community Survey. 2009-2011.

while only 1.4 percent of men lived in similar living situations.22These numbers are
slightly lower compared to the living arrangements of older Americans as a whole.
Approximately 19 percent of men aged 65 and older lived alone, compared with 37
percent of women aged 65 and older.23 In addition, about 4.1 percent of the 65 and
older population resided in institutional settings.
The rapid increase among the
oldest old population in Florida
has significant implications for the
living arrangements of those 85 and
older, including access to long-term
care and assisted living facilities. As
a population group, the oldest old
are at the highest risk for chronic
health problems, thus the expanding
elderly population has generated
increased demand for a range of
long-term care services.
Despite our rapidly growing elderly
population, Florida has not made
significant advances in access to
long-term care services.24 Florida
ranks poorly in the nation, placing
35th in terms of affordability and
access to long-term care facilities,
41st in terms of choice of settings
and provider, and 43rd in terms of
quality of care given by long-term
care facilities.25
22 American Community Survey. (2009-2011), op. cit.

23 U.S. Census Bureau. 2010.
24 U.S. Census Bureau (2012 December), op. cit.
25 AARP. Florida: 2014 A State Scorecard on Long-Term Services and Supports for Older Adults.

The Great Recession

The Great Recession
An Overview
The Great Recession of the late 2000s affected nearly all Americans in terms of
increasing financial insecurity and greater concerns about spending and borrowing
habits. The financial crisis impacted three markets —the housing, stock, and labor
markets—providing multiple pathways through which individuals, households, and
their assets may be negatively affected.
Yet, older adults and seniors have suffered a disproportionate share of economic
hardships following the advent of the recession in December of 2007. The Great
Recession hurt Florida’s seniors by reducing retirement investment accounts and
the value of equity in homes. Income and saving levels have fallen or stagnated for
many individuals and housing equity is far below 2008 values and is predicted to
remain at low levels for many more years.
The recession contributed to the already higher numbers of seniors who are
financially at risk. According to an Institute on Assets and Social Policy study, 78
percent of all senior households are vulnerable financially. This risk is elevated
among single senior households, mostly women, among whom more than one-third
are at serious financial risk. Most of this risk can be linked to low saving rates, weak
private pensions, and rising out-of-pocket medical expenses.26
Americans who are nearing retirement age—those Baby Boomers in their late 50s
and early 60s—have seen their earnings power diminish more than any other age
group in the aftermath of the recession. Their retirement savings and home values
declined precipitously at precisely the time when they were expecting to use these
funds to supplement their living expenses post-retirement. In fact, retirees as a
group will have $45 to $50 billion dollars less in income in the years leading up to
2030 than they will need to cover basic needs such as food, housing, and health care
costs and expenses deriving from nursing home and home health care.
In addition to struggling to meet basic needs on a shrinking budget, the Great
Recession has also hit older workers especially hard. The unemployment rate for
older Americans over the age of 55 reached 6.5 percent in 2012, and the length of
unemployment for older workers was 53 weeks. According to a survey of over 5,000
men and women workers over the age of 50 conducted by the AARP Public Policy
Institute, nearly 30 percent reported being unemployed at the time the survey was
conducted or employed currently but experienced involuntary employment during
the previous three years. Even if older workers are able to find re-employment, the
wages are usually substantially less than the level of compensation of their previous jobs.27
26 Macpherson, D. (2007), op. cit.
27 American Community Survey. (2009-2011), op. cit.

As this report later describes, the Great Recession had a
significant impact on Florida’s workers, homeowners, and
elderly population. As Florida
currently has 4.8 million baby
boomers fast approaching—or
already reaching—retirement
age, it is important to assess the
impact of the recession on the
elderly population.28
While the Great Recession
“officially” ended in the
first quarter of 2009 and the
stock market has recovered,
the negative effects of the
Great Recession on jobs and
wages lingers on. According
to the most recent data, the
employment rate is at a low of
59 percent and average income
is still down.
The following sections explore
the implications of the Great
Recession for Florida’s aging population. These include
migration to Florida, unemployment, layoffs, foreclosures,
dwindling saving rates, and Social Security and Medicare
depletion.
Migration: Florida as a Retirement Destination

Historically, Florida is a top retirement destination for
many so-called “snowbirds”—northern retirees looking to
move further south in search of warmer weather. While
retirees can have more than one residence, such as having
a vacation home, an individual can only declare primary
residency in one location. Many who opt to retire to Florida
establish full-time Florida residency by obtaining a Florida
driver’s license, registering to vote and filing for Florida

homestead status, and otherwise showing intent to establish residency in order
to obtain the advantages of Florida’s relatively generous tax and property laws.
Lured by the mild climate, relatively inexpensive housing and the lack of income
tax, the Sunshine State has traditionally welcomed an influx of retirees and older
adults. However, the impact and aftermath of the Great Recession has slowed the
stream of recent retirees and older adults into the state.
Related to the dismal real estate market and lingering effects of the recession
on Florida’s economy, there has been a 30 percent drop in out-of-state residents
applying for Florida driver’s licenses over the past five years. New York, one of
Florida’s top feeder states, has sent nearly 34,000 fewer residents to Florida
between the years of 2003 and 2008. New Jersey, another important feeder state,
has sent 11,000 fewer residents to Florida over the same time span.29 In 2009, for
the first time, more New Yorkers left for North Carolina than for Florida.30
Figure 1.
Median Household Income Index (HII) and Unemployment Rate by Month: January 2000 to February 2014
104 11
102 10
Seasonally Adjusted Unemployment Rate

100 9
HII (January 2000 = 100.0)
98 8
96 7
94 6
92 5
90 4
88 3
jan-05
apr-05
jul-12
oct-12
jan-13
apr-13
jul-13
oct-13
jan-14
jan-00
apr-00
jul-00
oct-00
jan-01
apr-01
jul-01
oct-01
jan-02
apr-02
jul-02
oct-02
jan-03
apr-03
jul-03
oct-03
jan-04
apr-04
jul-04
oct-04
jul-05
oct-05
jan-06
apr-06
jul-06
oct-06
jan-07
apr-07
jul-07
oct-07
jan-08
apr-08
jul-08
oct-08
jan-09
apr-09
jul-09
oct-09
jan-10
apr-10
jul-10
oct-10
jan-11
apr-11
jul-11
oct-11
jan-12
apr-12
Recessionary Periods = 104*

Month and Year
Seaonally Adjusted Household Income Index (January 2000 = 100.0)
Monthly Unemployment Rate (seasonally adjusted)
Sources: For income data: Sentier Research, LLC estimates of annual household income derived from the monthly Current Population Survey (CPS)
conducted by the U.S. Census Bureau; for the unemployment rate and the CPI-U: the U.S. Bureau of Labor Statistics.
10
29 Fewer Northerners are Relocating to Florida. (2012, September 11). Tampa Bay Business Journal.
Retrieved from http://www.bizjournals.com/tampabay/blog/morning-edition/2012/09/fewer-northerners-
are-relocating-to.html
30 Connor, M. (2011, October 7). Florida’s Retirement Destination Appeal is Waning. The Huffing-
ton Post. Retrieved from http://www.huffingtonpost.com/2011/10/07/florida-retirement-destination-
_n_1000743.html

Despite the relatively slow growth during the depths of the
recession, there are some signs that Florida’s population
may once again be on the upswing. Florida’s 65 and older
population grew by 4.5 percent—faster than any other age
group—in 2010.31 The growth of
Florida’s older adult population
is especially pronounced
in Sarasota and Charlotte
counties—two of the oldest
counties in the nation. Sarasota
County’s senior population
grew by 3.9 percent from
2011 to mid-2012. Most of the
recent growth stemmed from
an increase in the 65 and older
demographic--even in Florida
counties with traditionally
younger populations, such as
Manatee County.32
Unemployment
The media has recently referred to older adults aged 50
and up as the “new unemployables” as workers in their
50s are 20 percent less likely to be rehired than workers
in their mid twenties to late thirties. The average length
of unemployment for workers who are 55 and older is
eleven months—over three months longer than the average
duration for individuals in their twenties and thirties.33
According to AARP’s Public Policy Institute over 71 percent
of Baby Boomers pointed to the sluggish economy for their
struggle to obtain employment.
31 U.S. Census Bureau. (2010). Profile of the General Population and

32 U.S. Census Bureau. (2010). Profile of the General Population and
33 Kurtz, A. (2013, February 26). Workers over 50 are the New ‘Unem-
ployables.’ CNN Money. Retrieved from http://money.cnn.com/2013/02/26/
news/economy/over-50-unemployables/

When looking at annual unemployment rates by age group in the United States,
those over the age of 65 experienced an unemployment rate of 6.5 percent. This rate
is lower than the overall United States unemployment rate of 9.3 percent in 2009.
The difference is more likely due to discouraged older adults dropping out of the
labor force than an economic rebound for this age group.
Florida has a lower unemployment rate compared to the United States as a whole.
As of August 2013, Florida’s overall unemployment rate was 7 percent, down from
a high of 11.4 percent in February of 2010.34 Certain Florida counties experienced
higher unemployment rates than the Florida average in 2012, most notably
Madison, Hamilton, Putnam, Marion, and Citrus counties, with unemployment rates
of 10.9 to 13.5 percent.35 The unemployment rate of all individuals aged 55 to 64 in
Florida was at 6.4 percent in 2013.36
Layoffs
While many Americans are struggling to keep their jobs during the aftermath of
the Great Recession, job layoffs are particularly problematic for older Americans.
Older workers have not been laid off to the same extent as younger workers, but the
effects of the layoff can have much longer-lasting consequences. Many older adults
experience difficulties in securing employment if they are laid off from their current
position.37 Only one-third of workers aged 55 to 64 who lost their jobs between 2007
and 2009 were able to find full-time jobs by 2010. Many of the older workers who
were able to find jobs after being laid off from their current position experienced a
significant drop in earnings at their new position.
In 2010, there were 7,247 extended mass layoffs in the United States that affected
nearly 1.4 million workers38. In Florida, there were 264 extended mass layoffs that
dislocated nearly 134,000 individuals. Layoffs affecting workers aged 55 and up
made up 24.8 percent of the total number of extended mass layoffs in Florida, up
from 20.7 percent in 2010.39
34 Bureau of Labor Statistics. Economy at a Glance: Florida. Retrieved from http://www.bls.gov/eag/eag.
fl.htm
35 Florida Legislature Office of Economic and Demographic Research. Florida: An Economic Overview.
(2012, March 15). Retrieved from http://www.edr.state.fl.us
36 Miriam King, Steven Ruggles, J. Trent Alexander, Sarah Flood, Katie Genadek, Matthew B. Schroed-
er, Brandon Trampe, and Rebecca Vick. Integrated Public Use Microdata Series, Current Population Survey:
Version 3.0. [Machine-readable database]. Minneapolis: University of Minnesota, 2010.
37 Johnson, R.W., Mermin, G.B.T., and Uccello, C.E. (2006, January). Health Problems and Job Layoffs
Crack Retirement Nest Eggs. Older Americans’ Economic Security.
38 U.S. Census Bureau. 2010, op. cit.
39 Solis, H.L. and Hall, K. (2011, November). Extended Mass Layoffs in 2010. Bureau of Labor Statistics.

As many older Americans are concerned about having
enough money for retirement, job layoffs can inflict serious
damage to their retirement nest egg. Because those workers
who have been laid off spend fewer working years paying The average
into employer-sponsored pensions and Social Security and
also may be forced to draw from these plans in order to cover length of
living expenses while unemployed, their retirement savings unemployment for
take a substantial hit.40 In fact, it is estimated that the onset
of work disruptions and layoffs among older adults in their workers aged 55
50s and 60s reduces household wealth by 30 percent for and older is nearly
single individuals and by 14 percent for married couples.41
one year.
Duration of Unemployment by Age Group, 2007 & 2010
Median Weeks of Unemployment
35
31
30 29 29
25 24
21
20
15
9 9 11 11
10 8
5
0
25 - 34 years 35 - 44 years 45 - 54 years 55 - 64 years 65 years and
over
Ages
2007 2010
Source: Bureau of Labor Statistics
Note: Estimates have confidence intervals that are within +/- 23 percent of the estimate itself. All
statements made in text were found to be statistically significant.
Income
Since 2007, household income for older Americans has
fallen by 6 percent for adults aged 55 to 64. The median
income for households aged 65 and older was $25,757 in
2010, however, there are vast differences within this group
of older Americans. About 13 percent of older adults have an
40 Motoko, R. (2012, May 15). How Older Workers Weather Layoffs. The
New York Times.
41 Johnson, Mermin, and Uccello, op. cit.

income of under $10,000 while approximately 25 percent have a total income of
$50,000 or more. Nonmarried individuals have substantially lower incomes. This
is particularly prevalent among older age groups where there is a disproportionate
amount of single women. The average income for single individuals aged 80 and
older is roughly $16,000 while the average income for married couples in the same
age group is over double that number.42
The most common source of income for individuals aged 65 and older is Social
Security, with over 80 percent of individuals aged 65 and older receiving Social
Security benefits. Social Security provided at least 50 percent of total income
for approximately 53 percent of married couples and for roughly 74 percent of
nonmarried individuals. Even though Social Security provides the largest share
of older adults’ income, pensions and earnings provide about 18 percent and 30
percent of older adults’ income, respectively.
Percentage Receiving Social Security Benefits by

Relative Importance of Benefits to Total Income
80
74.1
70
65.3
60
53.1
50 46.1
40 36.3
30
20
10
0
50% or More of Income 90% or More of Income
2010
42 Social Security Administration. (2012, March). Income of the Aged Chartbook, 2010. Retrieved
from http://www.ssa.gov/policy/ocs/chartbooks/income_aged/

While Social Security and other benefits can provide a
secure foundation of income for many households over
the age of 65 to draw on, the recession and its aftermath
has affected the ability of older adults to recover a large
portion of their wealth and maintain adequate saving
The median income
levels. According to Barbara Bovbjerg, the managing for households
director of the U.S. Government Accountability Office, even aged 65 and older
though most retirees can expect to receive Social Security
benefits, “for many retirees even these will not be sufficient was $25,757 in
to maintain their standard of living.” Median household 2010.
net worth fell during the recessionary period, largely as a
result of increase in unemployment and lowered savings
ability. Many older adults are without any pension plan—44 However, there are
percent lack a defined benefit or defined contribution vast differences in
plan from their current employer. In fact, the number of
employers offering pension plans declined since 1990.43 average income
In Florida, the median income for older adults aged 45
within this group of
to 64 was about $52,000, while the median income for older adults - single
those 65 and older was under $35,000. Florida seniors older women have
have median annual incomes that fall slightly below the
savings threshold recommended by financial experts. disporportionately
While it is recommended by financial planners that retirees lower incomes
have enough money to replace about 70 percent of their
pre-retirement earnings, older Floridians only have 66.8 than their married
percent in income replacement rates.44 counterparts.
Poverty
Overall, Florida’s aging population has a poverty rate that
resembles the United States. There are several approaches
to measuring the prevalence of poverty and very low
incomes among the elderly. Most reports rely on federal
43 United States Government Accountability Office. The Effect of the
2007-2009 Recession on Older Adults. (2011, October 18). Testimony Before
the Subcommittee on Primary Health and Aging, Committee on Health,
Education, Labor and Pensions, U.S. Senate. Retrieved from http://www.gao.
gov/products/GAO-12-172T
44 Hicken, M. (2013, June 10). Seniors in 48 States Face Serious Income
Shortage. CNN Money. Retrieved from http://money.cnn.com/2013/06/10/
retirement/retirement-income/

poverty thresholds that use an individual’s pre-tax income adjusted for inflation
using the Consumer Price Index. However, many have noted the limitations of this
measure when studying aging populations.
Average Income by Source for Households in the Lowest, Middle, and

Highest of Five Income Groups, 2008
Lowest
(1st)
2008
Income quintile
0 // 6,000 6,300 6,600 6,900 7,200 7,500
Lowest $7,466 Total money income
(1st)
Middle $25,069
(3rd)
Highest $109,543
(5th)
0 20,000 40,000 60,000 80,000 100,000
Total money income (in dollars)
Social Security Earnings
Pensions and annuities Other
Asset income
Source OAO and SSA analyses of 2008 income data from March 2000 U.S. Census Bureau, Current Population Survey, Annual Social
and Economic Supplement.
Note: Households are defined here as either married people living together where one member is
65 or older, or a single person age 65 or older. Income from other people (such as adult children
living at home) is not included in household income. "Other" includes noncash benefits,
unemployment compensation, workers' compensation, and personal contributions.
For example, many experience economic hardship and financial strain—resulting in

difficulty in paying bills or affording basic consumer goods—but this is not captured
by the government’s official definition of poverty.45
An alternative to the official poverty rate is the Census Bureau’s “supplemental
poverty measure” which defines income and poverty differently than the official
measure by also adjusting for homeownership status and regional differences in
housing prices. Using this measure, poverty rates among those aged 65 and older
hover closer to 15 percent, or about one in seven seniors.46 In Florida, the number of
seniors with incomes below 100 percent of the supplemental poverty threshold was
slightly higher than the national average at 17 percent.47
45 Mirowksy, J. and Ross, C.E. (1999). Economic Hardship Across the Life Course. American Sociologi-
cal Review. 64, 548-569.
46 Short, K. (2011, November).The Research Supplemental Poverty Measure: 2010.U.S. Census Bureau.
http:/www.census.gov/prod/2011pubs/p60-241.pdf
47 Bureau of Labor Statistics, op. cit.

Nationwide, about 48 percent of older adults are defined
as having modest incomes—that is, their income falls
below 200 percent of the poverty threshold under the
supplemental poverty measure. This number is slightly The median income
higher among elderly Floridians. In Florida, half of seniors
aged 65 and older are defined as having modest incomes.48 for Floridians aged
65 and older was
under $35,000.
On average,
Florida seniors
have median
annual incomes
One of the concerns related to economic hardship among
that fall below the
the elderly is the increased risk of experiencing hunger. savings threshold
Indeed, there has been an increase in the number of elder recommended by
Americans- and Floridians who experience food insecurity.
In the nation overall, the number of seniors over the age financial planners.
of 60 experiencing the risk of hunger reached 8.3 million
Americans in 2010.49
In 2010, Florida ranked 9th in the nation in the number of
48 Current Population Survey, 2009-2011.

49 Ziliack, J.P. and Gundersen, C. (2013, August). The State of Senior
Hunger in America 2011: An Annual Report. Retrieved from http://www.
nfesh.org/wp-content/uploads/2013/08/State-of-Senior-Hunger-in-Ameri-
ca-2011.pdf

seniors facing the risk of hunger. Over 16 percent of Floridians, or nearly 700,000
individuals, over the age of 60 were classified as marginally food insecure.50 Given
that food insecurity and the threat of hunger are correlated with inadequate
nutrition and other poor health outcomes, the large number of older adults facing
hunger is a substantial public health concern.
Foreclosures
Contrary to popular belief that many older adults are financially secure and,
thus, largely unburdened by mortgage debt, many older Americans were severely
affected by the foreclosure crisis and collapse of the housing market occurring
in the midst of the Great Recession. Not only has mortgage debt been increasing
among American seniors, but over 1.5 million Americans over the age of 50 have
lost their homes since 2007. Among this demographic, those homeowners over the
age of 75 experienced the highest foreclosure rate with their rate of foreclosure
50 Ziliack, J.P. and Gundersen, C. (2012, May). Senior Hunger in America 2010: An Annual Report.
Retrieved from http:// http://www.nfesh.org/wp-content/uploads/2013/03/2010-Senior-Hunger-Report.pdf

growing more than eightfold between 2007 and 2011 to
reach 3.2 percent. In addition, nearly 3.5 million older
adults are at risk for foreclosure and owed more on
their home than their home’s actual value. While the
foreclosure rate on prime mortgage loans for American Nearly one in seven
seniors was at a low one tenth of one percent in 2007, in seniors lives in
2011 it was at 2.3 percent—a rate nearly 23 times higher
than four years ago.51 The growing rate of foreclosures
poverty.
among older Americans, and the devastating effects
it can have on seniors’ financial security, can be tied
to decreasing property values, dwindling savings and
investment portfolios, increases in medical care costs, and
pension cuts compounded by the overall downturn in the
economy.52
Within Florida, the southern part of the state was hit
particularly hard. In 2009, Miami experienced a foreclosure
filing rate of one in twenty-eight homes, while Tampa saw
a foreclosure rate of one in thirty-nine homes53. The five
Florida counties hardest hit by foreclosures were Flagler,
Hernando, Gadsden, Saint Lucie, and Wakulla counties.54 Over 1.5 million
In 2007, there were roughly 6,000 Florida homeowners older Americans
over the age of 50 facing foreclosure and another 53,000 have lost their
in delinquency and facing the risk of losing their home.
As of September 2014, Florida had the highest foreclosure homes since 2007.
rate in the country. Miami has one of the highest rates of
foreclosures within the state.55 Florida ranked fourth in the
51 Fleck, C. (2012, July 19). Mortgage Crisis Impacts Seniors. AARP

Public Policy Institute. Retrieved from http://www.aarp.org/money/credit-
loans-debt/info-07-2012/mortgage-crisis-impacts-older-americans.html
52 AARP Public Policy Institute. (2012, July 19). Last Five Years Saw
Unprecedented Numbers of Older Americans Lose Homes or Face Foreclo-
sure. Retrieved from http://www.aarp.org/about-aarp/press-center/info-07-
2012/AARP-Study-Foreclosure-Report.html
53 Christie, L. (2009, July 30). Foreclosures: How Bad is Your City? CNN
Money.
54 Florida Real Estate Trends and Market Info: Foreclosure Rates for
Florida. (2013, September).
55 Marma, K. (2013, June 19). Help for Seniors with Mortgage Foreclo-
sure Problems. AARP Florida. Retrieved from http://states.aarp.org/help-for-
seniors-with-mortgage-foreclosure-problems

nation in terms of having the highest foreclosure rates for homeowners over the age
of 50—falling just behind Colorado, Michigan, and Nevada. Potentially increasing
the risk of foreclosures among seniors, Florida also has one of the highest housing
cost burdens among older adults who have yet to pay off their mortgage. Forty eight
percent of homeowners over the age of 50 were housing cost-burdened and over 20
percent are contributing at least half of their income to housing costs.56
Savings
Many workers over the age of 50 have experienced shrinking retirement savings
and a reduction in assets during, and after, the onset of the Great Recession
in December of 2007.57 Between the years of 2007 and 2009, one in four older
Americans spent nearly all of their retirement savings. Weathering the shocks of
increasing unemployment and health care costs, rapidly shrinking pensions and
investment portfolios, and diminishing home values, older Americans were hit
particularly by the aftershocks of the Great Recession. Reflecting the uncertainty
that many older Americans are feeling, almost half of older workers surveyed by
56 Harrell, R. Insight on the Issue: Housing for Older Adults: The Impacts of the Recession. AARP Public
Policy Institute. Retrieved from http://assets.aarp.org/rgcenter/ppi/liv-com/insight53.pdf
57 Delaney, A. (2011, May 24). Retirement and the Recession: Savings Destroyed for One out of Four
Older Workers, Says AARP Survey.

AARP’s Public Policy Institute in 2010 said they predicted
they would have a “less economically secure” retirement
than that of their parents. Over half of Boomers surveyed
said they felt less financially secure in 2010 than they felt Between 2007
in 2007 and nearly two-thirds of those surveyed said they
had suffered a reduction in retirement savings.58 and 2009, one
According to the Federal Reserve, nearly half of older in four older
adults aged 65 to 74 have no money in any retirement Americans spent
accounts.59 The lack of savings and dwindling equity and
investment portfolios among older Americas has led some
nearly all of
to start collecting Social Security benefits earlier than they their retirement
had originally planned. Nearly 14 percent of those surveyed savings.
by AARP said they began collecting Social Security benefits
earlier even as they traded in reduced benefits for earlier
access to Social Security funds.60
Older Floridians are also facing growing uncertainty and Almost half of
increasing financial instability in the wake of the Great older Americans
Recession. Only one in twelve Floridians plan to retire
at the same age they expected to five years ago and less have no money
than 30 of percent private-sector employees participate in in retirement
their company retirement plan, putting Florida last in the
nation.61 Nearly one-third of retired Floridians rely entirely accounts.
on Social Security benefits for their income each month,
higher than the national average of 25 percent.62
Only one in twelve

58 AARP Public Policy Institute. Boomers and the Great Recession:
Floridians plan to
Struggling to Recover. Retrieved from http://www.aarp.org/content/dam/ retire at the same
aarp/research/public_policy_institute/econ_sec/2012/boomers-and-the-
great-recession-struggling-to-recover-v2-AARP-ppi-econ-sec.pdf age they expected
59 AARP Public Policy Institute. Cited in: “Retirement and the Reces-
sion: Savings Destroyed for One out of Four Older Workers, Says AARP
to before the
Survey.” http://www.huffingtonpost.com/2011/05/24/retirement-savings- Great Recession.
older-workers-recession_n_866109.ht m
60 AARP Public Policy Institute, Boomers and the Great Recession:
Struggling to Recover, op. cit.
61 Gehrke-White, D. (2013, May 13). Boomers Facing Uncertainty of
Retirement, Maybe Working Years More Than They Thought. Sun-Sentinel.
62 AARP Public Policy Institute: Boomers and the Great Recession:
Struggling to Recover, op. cit.

Impact on Social Security and Medicare
During the midst of the Great Recession, the financial health
of Social Security, an important safety net and source of
income for American retirees, was rapidly declining. Due to
recessionary cuts in payroll taxes, occurring just as many
Baby Boomers were set to retire, Social Security assets
declined precipitously. The Social Security (OASI) trust
fund is expected to run out of assets by 2034. The projected
deficits could be covered by gradually increasing payroll
taxes by around 2% or by reducing benefits. According to
the 2014 Annual Report by the Social Security Board of
Trustees, by the year 2020 Social Security spending was
forecasted to exceed income and revenues—about one year
earlier than they predicted in their 2008 annual report.63 Yet
in 2010, Social Security sent out more in benefits to retirees
than they will receive in revenues. A central reason for the
precipitous depletion in Social Security that occurred during
the recessionary period is that unemployment increased and
older adults began to file for Social Security benefits earlier
than expected. Compounding the dilemma is that there are
fewer workers, and thus, fewer paychecks to tax, which could
strengthen Social Security’s revenue.64
The pressures on the Social Security system will only
continue to grow. For the next 75 years, the Social Security
Administration will have to raise over $5 trillion dollars in
revenue in order to pay out all benefits to Social Security
recipients.65
The Great Recession hurt the financial health of Medicare—
the health insurance program for older adults aged 65 and
older and disabled individuals—to an even greater extent. In the midst of the
63 Board of Trustees, Federal Old-Age and Survivors Insurance and Federal Disability Insurance Trust
Funds. The 2014Annual Report of the Board of Trustees of the Federal Old-Age and Survivors Insurance and
Federal Disability Insurance Trust Funds. Retrieved from http://www.ssa.gov/oact/tr/2014/tr2014.pdf
64 Congressional Budget Office. (2010, October 22). CBO’s 2010 Long-Term Projections for Social
Security: Additional Information. Congress of the United States. Retrieved from http://www.cbo.gov/publica-
tion/21905
65 Board of Trustees, Federal Old-Age and Survivors Insurance and Federal Disability Insurance Trust
Funds, op. cit.

recession, some estimates predicted that
Medicare’s Hospital Insurance Trust Fund
would be exhausted by 2017. As of 2014,
however, the Board of Trustees reported a “Age-based
depletion date of 2030.66 Medicare faced
more immediate financial strain during retirement arbitrarily
the recession than Social Security as severs productive
not only did it face a decline in revenues persons from their
due to lower payroll tax collections, but
it is also had to cope with the burden of
livelihood, squanders
increasing health care costs. their talents,
Increasing the strain on Medicare and
scars their health,
reflecting the aging of Baby Boomers, strains an already
the Medicare Board of Trustees forecast overburdened Social
in 2014 that the number of Medicare Security system, and
beneficiaries will increase by to 64
million recipients in 2020—compared to drives many elderly
47 million recipients in 2010. In addition, people into poverty
due to the substantial increase in health and despair. Ageism
care costs and increased demand for
medical services by the elderly, Medicare
is as odious as racism
spending per recipient is forecasted to and sexism.”
increase by over 50 percent by 2018 to
$17,000 in 2018.67 - Claude Pepper
In the next section, costs related to

Medicare and Medicaid will be given
66 Board of Trustees, Federal Hospital Insurance and Federal Supplemen-
tary Medical Insurance Trust Funds. The 2014 Annual Report of the Board of
Trustees of the Federal Hospital Insurance and Federal Supplementary Medical
Insurance Trust Funds. Retrieved from http://www.cms.gov/Research-Statis-
tics-Data-and-Systems/Statistics-Trends-and-Reports/ReportsTrustFunds/
downloads/tr2014.pdf
67 Board of Trustees, Federal Hospital Insurance and Federal Supplemen-
tary Medical Insurance Trust Funds. The 2014 Annual Report of the Board of
Trustees of the Federal Hospital Insurance and Federal Supplementary Medical
Insurance Trust Funds. Retrieved from http://www.cms.gov/Research-Statis-
tics-Data-and-Systems/Statistics-Trends-and-Reports/ReportsTrustFunds/
downloads/tr2009.pdf

further attention. The implications of the passage of the Affordable Care Act in
2010 include an improvement in Medicare’s long-term financial outlook through
reductions in future Medicare spending and slower growth in Medicare payment
rates.68
Figure II.E1 -- HI Trust Fund Balance at Beginning of Year as a Percentage of

Annual Expenditures
200%
Historical Estimated
150%
100%
50%
0%
1990 1995 2000 2005 2010 2015 2020 2025 2030 2035
68 Peter G. Peterson Foundation. (2010, September 17). The Financial Condition of Medicare. Re-
trieved from http://www.pgpf.org/Issues/Spending/2010/08/05/The-Financial-Condition-of-Medicare

Health Care, Insurance Costs

Health Care, Insurance Costs
Long Term Care
In 2009 a total of 1.3 million seniors in the United States, or 4.1 percent, resided
in nursing homes. The percentage of the elderly living in institutional settings
increases dramatically with age. For example, only 3.5 percent of the population
aged 64 to 75 years old lived in nursing homes—compared to 13 percent of
individuals over the age of 85 as of 2009.69 Florida mirrors the national picture, with
3.7 percent of seniors over the age of 65 living in long term care facilities.70
With the earliest Baby Boomers beginning to turn 65 in 2011, the population
of older adults is growing rapidly in the United
States. By the year 2030, 20 percent of the nation’s
population will be 65 years or older and the growth
of the “oldest old”—those over the age of 85—will
increase by over 50 percent.71 Given the projected
growth of the elderly population, the demand for
assisted living and other out-of-home care will
undoubtedly expand in the coming years. However,
the magnitude of this growth is less predictable given
the current uncertainties in insurance and savings
brought on in part by the recession.
Today’s seniors struggle to obtain quality assisted
living care. Simply put, quality long term care is out
of reach for most seniors, given that the average
yearly cost of nursing home care is over $75,000
dollars72. At the same time, rising health care costs
and changes to Medicare and Medicaid will only drive
the costs higher and push quality long term care even
further away from most seniors. The federal Centers
for Medicare and Medicaid services cut nearly $16 billion in skilled assisted living
facility funding in 2009—in addition to Medicare and Medicaid funding cuts at the
state level. Overall, 24 states slashed funding for assisted living and nursing home
69 A Profile of Older Americans: 2011. Administration on Aging. U.S. Department of Health and Hu-
man Services. Retrieved from http://www.aoa.gov/AoAroot/Aging_Statistics/Profile/2011/docs/2011profile.
pdf
70 American Community Survey. 2009-2011.
71 Yoder, S. (2012, January 26). The Coming Nursing Home Shortage. The Fiscal Times. Retrieved from
http://www.thefiscaltimes.com/Articles/2012/01/26/The-Coming-Nursing-Home-Shortage
72 Galewitz, P. (2010, April 23). Despite Federal Help, States Struggle to Move People Out of Nursing
Homes. NPR. Retrieved from http://www.npr.org/templates/story/story.php?storyId=126217779

care and other healthcare services for seniors.73 These
budgetary cuts to caregiving facilities come just as aging
Baby Boomers may soon need the services that assisted
living provides. Medicare
Florida caregiving facilities also suffered from cutbacks in provided health
Medicare-funded skilled assisted living facilities in 2011
when over $331 million dollars were slashed from funds insurance to over
designated for Medicare-funded skilled nursing care.74 40 million older
With Florida’s elderly population expected to grow by over
55 percent between 2010 and Americans in
2030 and the population of 2010.
those 65 and older forecasted to
comprise 24 percent of Florida’s
population by 203075, it
appears highly likely that aging
Floridians will face a shortage About 50 million
in quality, skilled caregiving
facilities. Americans were
If this growing population enrolled in
is unable to afford or find Medicaid in 2009.
available long-term care, the
burden of care will fall on
their families. In 2009, over 43
million Americans provided
some type of family caregiving Over 3 million
for elderly family members.76
At the same time, it should be Florida seniors
73 America’s Nursing Homes in Economic Peril After Recession and received Medicare
Cuts in Government Funding. (2009, October 5). New York Daily News. Re-
trieved from http://www.nydailynews.com/2.1353/america-nursing-homes-
benefits.
economic-peril-recession-cuts-government-funding-article-1.383181
74 Reed, E. (2011, September 29). Budget Cuts Threaten Long-Term
Care. Sarasota Herald-Tribune. Retrieved from http://www.heraldtribune.
com/article/20110929/COLUMNIST/110929537
75 The Florida Legislature, Office of Economic and Demographic Re-
search. (11 May, 2012). Florida’s Economic Future & the Impact of Aging in
Place.
76 National Alliance for Caregiving in collaboration with AARP. (2009
November). Caregiving in the U.S. 2009. Retrieved from http://assets.aarp.
org/rgcenter/il/caregiving_09_fr.pdf

noted that older Americans are remaining healthy and staying active for longer and
this may offset the demand for intensive healthcare services and facilities.
Medicare and Medicaid Costs

Medicare and Medicaid continue to serve fundamental roles in the health care
provision of our elders. Medicare provided health insurance to over 40 million
individuals aged 65 and older in 2010—but this number is expected to rise to about
78 million people by
2030.77 About 50 million
individuals were enrolled
in Medicaid in 2009 and
nearly 60 percent of
nursing home residents
used Medicaid to help
pay for their stay in long-
term care facilities.78
Nationally, total
Medicare spending per
enrollee was $8,649
dollars while total
Medicare program
payments averaged
over $300 million in
2008. In Florida, total Medicare spending per enrollee was slightly higher than the
national average at over $10,000 dollars and total state Medicare program payments
averaged over $24 million.79 Total Medicaid expenditures as a percent of total state
spending averaged around 23 percent of the Florida’s budget in 2008.80
77 Board of Trustees, Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust
Funds, op.cit.
78 Berwick, D. (2010, December 21). 2010 Actuarial Report on the Financial Outlook for Medicaid.
Department of Health and Human Services. Retrieved from http://www.cms.gov/Research-Statistics-Data-
and-Systems/Research/ActuarialStudies/downloads/MedicaidReport2010.pdf
79 AARP Public Policy Institute. Florida: Quick Health Facts 2012. Retrieved from http://www.aarp.org/
content/dam/aarp/research/public_policy_institute/health/florida-quick-health-facts-2012-aarp-ppi-health.
pdf
80 AARP Public Policy Institute. Florida: Quick Health Facts 2010. Retrieved from http://assets.aarp.
org/rgcenter/health/d19305_healthfacts_QuickFacts2010.pdf

In Florida, over 3 million seniors—about 17 percent of the
population—received Medicare benefits, while only one
in twelve received Medicaid benefits.81 Nearly 99 percent
of Florida seniors were enrolled in Medicare in 2009—
providing near universal healthcare insurance coverage.
However, many Floridians still struggle with high out of
pocket healthcare expenses, which can total over $7,000
dollars annually for the average Florida senior.82
Insurance Coverage
Only one in Uninsured Rates By Race
ten Medicare Amoung Americans Ages 50 to 64
recipients’ relies 40
only Medicare for
their healthcare 35
needs. The vast 33
majority of 30
beneficiaries
Percent Uninsured
have some type 25

of supplemental
coverage to cover 20 20
any additional
expenses. Over 15
70 percent 12
of Medicare 10
recipients have
either employer- 5
sponsored or
private insurance 0
to supplement Hispanic African American Caucasian
their Medicare
81 Medicaid Expansion Would Reach Only Low-Income Floridians, Al-
most All of Whom Lack Access to Affordable, Quality Coverage. (July 2012).
Florida Center for Fiscal and Economic Policy. Retrieved from http://www.
fcfep.org/attachments/20120724--Medicaid%20Eligibles%20in%20Expan-
sion.pdf
82 Why Social Security and Medicare are Vital to Florida’s Seniors.
AARP Public Policy Institute. Retrieved from http://www.aarp.org/content/
dam/aarp/research/public_policy_institute/econ_sec/2012/FL-SSandMedi-
carefact-sheet-AARP-ppi-econ-sec.pdf

coverage. Also, despite the perception that all seniors qualify for Medicare, seniors
must have worked for ten years and paid taxes to receive Medicare’s primary form
of benefits (Part A) for free. Those individuals who do not qualify based on their
employment history can opt to pay a monthly premium for Part A coverage. Only 1
percent of Part A recipients pay these monthly premiums.83 Nearly 9 million seniors
are “dual eligible”—meaning they are enrolled in both Medicare and Medicaid, yet
seniors make up only 9 percent of the total enrollment in Medicaid.84
The degree to which Medicare provides insurance coverage to the population can
be seen by contrasting the 99 percent coverage rate to the rate for those who are
approaching retirement and Medicare qualifying age. Among those aged 50 to 64 who
are not yet eligible for Medicare coverage, a significant number are uninsured. For
example, in 2010 nearly 9 million older adults aged 50 to 64 were uninsured in 2010.
Further, the risk of being uninsured varies considerably across social groups. Nearly
one of out every three Hispanics aged 50 to 64 and one out of every five African
Americans of the same age were without health insurance in 2010.85
The percent of 50 to 64 year olds in Florida is one of the nation’s highest. Over 22
percent of the population aged 50 to 64, or over 700,000 individuals, were without
health insurance.86 The implementation of the Affordable Care Act will likely affect
this issue but it as of yet unclear how much.
83 The Medicare Beneficiary Population. AARP Public Policy Institute. Retrieved from http://assets.aarp.
org/rgcenter/health/fs149_medicare.pdf
84 Policy Basics: Introduction to Medicaid. (2013, May 8). Center on Budget and Policy Priorities. Re-
trieved from http://www.cbpp.org/cms/index.cfm?fa=view&id=2223
85 Smolka, G., Multack, M. and Figueiredo, C. Health Insurance Coverage for 50- to 64-Year-Olds. AARP
Public Policy Institute. Insight on the Issue. Retrieved from http://www.aarp.org/content/dam/aarp/research/
public_policy_institute/health/Health-Insurance-Coverage-for-50-64-year-olds-insight-AARP-ppi-health.pdf
86 Smolka, Multack, and Figueiredo, op. cit.

Concluding Remarks
What quality of life will older adults experience in Florida in the next several
decades? Will this time be looked upon as their Golden Years, or years
spent worrying about not having enough “gold” in their pocketbooks? This
report identifies recent trends in Florida and the U.S. that add uncertainty to
projections about the future experiences of Florida’s older adults, clouding the
crystal ball. Prominent among these trends are the dramatic relative growth of
the older adult population and rapidly increasing costs associated with medical
care (especially long-term care), stagnant incomes and inadequate savings for
most pre-retirement adults, and uncertain futures for the programs created to
prevent poverty in old age and provide elders access to health care. To a much
greater extent now than when previous issues of the Florida’s Aging Population
report were released, we are faced with enormous challenges and very significant
policy choices that will profoundly affect the later lives of generations to come.
Living longer is less important than having a good quality of later life
characterized by meaningful social connections, active engagement, and
independent living, to the greatest extent possible given one’s physical and
mental capabilities. Medical and psychological disciplines tend to contribute to
older adults’ pursuit of “successful aging” by finding ways to enhance physical
and cognitive ability at older ages. Social scientists, policymakers, city planners,
and advocacy organizations stand to make their biggest impact by increasing
older adults’ income security and health care access, and by investing in
communities in ways that support independent living. Achieving these policy
goals requires a broad-based, multi-organizational approach, such as that
adopted by programs like Florida’s “Safe Mobility for Life Coalition” (see the
end of this report for more information on the coalition). The authors of this
report see government agencies playing a fundamental role of in addressing
challenges to retirement security, health care access and affordability, and living
independently. Senator Claude Pepper did, too.


Programs Affiliated with the
Pepper Institute

October 2014
Improving Safety, Access, & Mobility

For Aging Road Users
F
lorida leads the nation with over 18 percent of its Percentage of Population Age 65 and Older
population over age 65 and by 2030, over 27 percent
will be 65 and older. To meet the transportation
safety challenges of an aging population, Florida’s
Safe Mobility for Life Coalition has developed an Aging Road
User Strategic Safety Plan. The goal of our plan to improve
the safety, access, and mobility of Florida’s aging population
while reducing their crash, injury, and fatality rates.
Safe Mobility for Life Coalition

Florida Department of Transportation along with FSU’s
Pepper Institute on Aging and Public Policy, reached out to
agencies and organizations who have responsibilities and *estimate
interests in aging road user safety and mobility to form a
state-wide coalition. Our membership includes: Aging Road User Strategic Safety Plan
To reduce crash rates for Florida’s aging road users, we
developed a broad strategic safety plan. This plan uses a
positive approach to strike a balance between safety and
mobility to help Floridians maintain independence and
remain active in their community even after they transition
from driving. There are ten emphasis areas:
Advocacy and Policy
Florida Coalition
Aging in Place
CTST
COMMUNITY TRAFFIC SAFETY TEAMS
Assessment, Remediation, and Rehabilitation
Data Collection and Analysis
Licensing and
Enforcement
Other Road Users
Outreach and
Education
Prevention and Early
Recognition
Program
Management,
Evaluation, and
Resources
Transitioning from
Driving

Transportation Safety and Mobility Resources Find-a-Ride Database
The Coalition uses the following resources to help us meet Working with the University of Florida’s Florida Senior Safety
our goals. Resource Center we provide direct access to over 800 local
transportation options through our website. Visit www.
Roadway and Pedestrian Improvements SafeandMobileSeniors.org/FindaRide.
FDOT continues to implement and htm to find options available in your
support safety countermeasures
on both state and local roads to
Aging Road User: community.
help compensate for the visual and A driver, passenger, Aging in Place Checklist
physical issues associated with aging. pedestrian, bicyclist, transit- Our interactive checklist was created
Improvements that help older adults, rider, motorcyclist, or to help people determine if their
benefit road users of all ages. operator of a non-motorized community has features and services
that contribute to a rewarding,
Florida CarFit vehicle who is over the age of
healthy, and mobile life as they grow
CarFit is an educational safety program 50 with a special focus on the older. After completing the checklist
created by the American Society on 65 years and older age group. individuals will learn to recognize how
Aging and developed jointly with AAA, well a community meets their mobility
AARP, and the American Occupational needs to successfully age in place.
Therapy Assoc. CarFit is designed to keep drivers safe and Visit www.SafeandMobileSeniors.org/AginginPlace.htm for
comfortable by improving the “fit” between the them and more information.
their vehicle. CarFit events are held state-wide to promote
safe driving conversations and provide community safety Safe Mobility for Life Resource Center
and mobility resources. Visit www.car-fit.org/carfit or call Materials to promote and
1-855-409-0200 for more information. educate on aging road user
issues, including our guide,
www.SafeandMobileSeniors.org (www.FLsams.org) checklist, brochures, and tip
A one-stop website created and maintained by FDOT to cards that support the Aging
put safety, access, and mobility tools and resources all Road User Strategic Plan are
in one place. The website provides information to help available.
all stakeholders, including older adults, families and
caregivers, physicians, law enforcement, and communities To request materials, contact:
to help improve the safety and mobility of Florida’s aging Pepper Institute on Aging and Public Policy
population. Safe Mobility for Life Resource Center
Florida’s Guide for Aging Drivers Tallahassee, FL 32306
This free guide is a printed version Phone: (850) 644-8145
of our website and designed to help Email: safe-mobility-for-life@fsu.edu
Floridians learn how to continue
to safely drive while also sharing For more information, contact:
information to help prepare and plan Gail M. Holley
ahead to meet their mobility needs Safe Mobility for Life Program and Research Manager
after transitioning from driving. The Florida Department of Transportation
guide has five sections containing State Traffic Engineering and Operations Office
helpful state and local information 605 Suwannee Street, M.S. 36
and resources related to: Tallahassee, FL 32399-0450
Promoting Safe Mobility for Life Phone: 850-410-5414
The Impact of Aging on Driving Email: gail.holley@dot.state.fl.us
Am I Safe to Drive? Website: www.safeandmobileseniors.org (www.FLsams.org)
Keeping Safe While Driving
Retirement from Driving

Osher Lifelong Learning
The Osher Lifelong The Osher Lifelong Learning Institute (OLLI) at

Learning Institute Florida State University provides premier educational
and social programs for adults age 50 and older in
at The Florida State a stress free
environment
University where there are
no tests and
no homework:
Learning for the
fun of learning.
OLLI provides
academic courses,
field trips, weekly
lectures, a writers’ group, a book club and other
learning and social activities.
OLLI at FSU is associated with the Pepper Institute

on Aging and Public Policy and receives the majority
of funding from member dues and class registrations
along with a generous grant from The Bernard Osher
Foundation. The Bernard Osher Foundation funds
lifelong learning institutes at over 100 colleges and
universities: www.osherfoundation.org
OLLI offers scholarly

classes during a 6-week
Spring Term and a
6-week Fall Term. OLLI
classes meet on campus
at The Claude Pepper
Center, Westminster
Oaks Maguire Center,
and at several offsite
Having the time locales. During May
of each year, OLLI has
of our lives! a lively 3-week term
with classes held at off-
campus locations. During each term classes typically
meet once a week for 2 hours each session and are

Discover the
OLLI Membership Benefits
Free Noon Lectures
Possibilities! OLLI social events and functions including

the Annual Holiday Luncheon, Spring
Luncheon, and the Dedman Dinner
Relive History
Experience the Arts Clubs: Book; Spanish; Travel;
Create a New Passion Writer’s; Walking and Art
Cultural arts activities
offered during evening hours and Saturdays.
Our classes are taught by current or retired Regional field trips, and out of town
faculty from FSU, FAMU, and TCC. overnight excursions
Graduate students in good standing are also Study Abroad programs
invited to teach. Topics range from Art to
World History. OLLI classes will educate, OLLI at FSU Newsletter
amuse, and challenge you.
Weekly electronic news and
In addition schedule reports
to academic Opportunity to enroll in OLLI classes
classes, OLLI
at FSU offers a A permanent OLLI ID
Noon Lecture name badge and lanyard
Series and the
College of FSU Library privileges
Social Science’s
Socialize with others who enjoy learning!
Broad Lecture
Series, both
featuring well known and informed speakers
in For information about OLLI at FSU
a wide array of topics. There are trips to courses please visit our website
fascinating locations, including the opera at olli.fsu.edu You can also find us
and theatre, events at local galleries, outings on Facebook at The Osher Lifelong
to FSU sporting events and opportunities to Learning Institute at The Florida State
travel and study abroad. OLLI at FSU has University.
a variety of clubs including: book, travel,
walking, art and Spanish clubs. There’s
also a dynamic, published writers’ group.
Something for everyone! OLLI at FSU
Corporate Partner
pepperinstitute.fsu.edu

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Pepper Institute on Aging and Public Policy

636 West Call Street

February 20, 2015

John Reynolds, Justine Gunderson, and Melissa Bamford

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Pepper Institute on Aging and Public Policy 4

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About the Authors

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Pepper Institute on Aging and Public Policy

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The Growth of the “Oldest Old”  17

The Great Recession  21

Health Care, Insurance Costs  39

Programs Affiliated with the Pepper Institute 47

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Florida’s Status Relative to Other States

Pepper Institute on Aging and Public Policy 12

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Santa Rosa Okaloosa

Washington Jefferson Nassau

Hendry Palm Beach

8 U.S. Census Bureau (2010), op. cit.

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Florida’s Growing Aging Population

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Florida’s Percent Population Growth By Age Group

12 U.S. Census Bureau. (2010). USA People QuickFacts, op. cit.

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Baby Boomers: The Future of the Aging Population

Pepper Institute on Aging and Public Policy 18

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18 U.S. Census Bureau. (2012 December), op. cit.

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22 American Community Survey. (2009-2011), op. cit.

Pepper Institute on Aging and Public Policy 20

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Pepper Institute on Aging and Public Policy 22

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Migration: Florida as a Retirement Destination

28 U.S. Census Bureau. (2005), op. cit.

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Seasonally Adjusted Unemployment Rate

Recessionary Periods = 104*

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31 U.S. Census Bureau. (2010). Profile of the General Population and

Florida's Aging Population

Florida's Aging Population

Florida's Aging Population

The Growth of the “Oldest Old” 17

The Great Recession 21

Health Care, Insurance Costs 39

Programs Affiliated with the Pepper Institute 47